Healthcare Provider Details
I. General information
NPI: 1255145751
Provider Name (Legal Business Name): MEDCORP HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8070 CASTLETON RD
INDIANAPOLIS IN
46250-2005
US
IV. Provider business mailing address
8070 CASTLETON RD
INDIANAPOLIS IN
46250-2005
US
V. Phone/Fax
- Phone: 317-363-3828
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747A0650X |
| Taxonomy | Attendant Care Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RASHINA
DENISE
BARDEN
Title or Position: OWNER
Credential:
Phone: 317-363-3828